Figure 1 - available via license: Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Content may be subject to copyright.
Bladder biopsy section. Haematoxyline & Eosin section illustrates dense amphorous pink acellular material with the presence of an edge of benign uroithelium.
Source publication
Primary and localized amyloidosis of the urinary tract is considered to be a rare clinical entity with approximately 160 cases documented in the literature. Here we present a case of a 77 year old gentleman with painless visible hematuria. Flexible cystoscopy revealed abnormal and polypoidal bladder mucosa. Transurethral resection of these lesions...
Context in source publication
Context 1
... revealed transitional epithelium with extensive areas of amorphous eosinophillic material with foci of embedded tran- sitional epithelium (Fig. 1). Congo-red staining was brightly organeophillic with green-apple birefringence; these findings were consistent with amyloid deposits (Fig. 2). Of note, there was no other evidence of dysplasia or malignancy. ...
Similar publications
Citations
... Hematuria as a presenting feature of isolated renal AL amyloidosis is relatively uncommon. To date, there are seven reports discussing patients with hematuria who were later diagnosed with either isolated or systemic amyloidosis [5][6][7][8][9][10]. Of these seven reports, three articles discussed hematuria as a presenting feature of AL amyloidosis [5,7,8]. ...
... To date, there are seven reports discussing patients with hematuria who were later diagnosed with either isolated or systemic amyloidosis [5][6][7][8][9][10]. Of these seven reports, three articles discussed hematuria as a presenting feature of AL amyloidosis [5,7,8]. ...
... Isolated renal AL amyloidosis was mostly diagnosed in females [6]. The presenting symptom in our study was abdominal pain; however, patients in previous reports also presented with generalized weakness [6], night sweats [6], rashes [6], hematuria [5,7,8,9], and multiorgan failure [8]. Hematuria was most commonly found in cases with senile wild-type systemic amyloidosis [8], transthyretin amyloidosis of the urinary bladder [10], AA amyloidosis [6], and amyloidosis with concomitant crescentic glomerulonephritis [7]. ...
The prevalence of light chain (AL) amyloidosis, characterized by the deposition of amyloid chains, is gradually increasing. The clinical features of the disease depend upon the location of amyloid deposition and can manifest in many forms. Although laboratory investigations can reveal proteinuria and change in complement levels, hematuria and low complement levels are rarely reported. There are very few cases of renal AL amyloidosis presenting as persistent hematuria. We present the case of a 54-year-old female presenting with abdominal pain, proteinuria, and moderate persistent hematuria on admission who was later diagnosed with AL amyloidosis on biopsy.
... The risk for amyloidosis of the seminal vesicles increases with age, with 21% of men over the age of 75 found to have seminal vesicle amyloid deposits [7]. Secondary Amyloidosis (AA) is typically associated with chronic inflammation, usually with conditions such as rheumatoid arthritis, chronic osteomyelitis, or malignancies [8]. This patient initially presented with hematuria, which is the most common symptom of amyloidosis of the urinary tract [8]. ...
... Secondary Amyloidosis (AA) is typically associated with chronic inflammation, usually with conditions such as rheumatoid arthritis, chronic osteomyelitis, or malignancies [8]. This patient initially presented with hematuria, which is the most common symptom of amyloidosis of the urinary tract [8]. Amyloidosis can further be divided based on localized versus systemic. ...
A 66-year-old man presented with a history of hypertension, benign prostatic hyperplasia (BPH), and urinary retention and multiple hospitalizations for gross hematuria with clots and clot urinary retention. A prostatic biopsy revealed localized amyloidosis of the seminal vesicles. The patient underwent transurethral resection of the prostate with postoperative clot urinary retention and gross hematuria. After it was resolved and the patient recovered, a postoperative hematologic evaluation revealed a diagnosis of von Willebrand’s diseases, a condition that results in bleeding diathesis from a mutated gene in the blood coagulation pathway involving factor VIII. This case of secondary amyloidosis of the seminal vesicles, along with gross hematuria and von Willebrand’s disease provides unique insight into the correlation between amyloidosis and blood coagulation abnormalities.
... Amyloidosis refers to a group of conditions manifested by the abnormal deposition of amyloid protein in tissues and organs. Primary amyloidosis can occur in those with disordered immune cell function such as multiple myeloma, while secondary amyloidosis can occur as a complication of a chronic inflammatory or tissue destructive disease. 2 Deposition of amyloid within the urinary tract can occur in many different locations, however the kidney is almost always involved sec- 3 The presentation of bladder amyloidosis is very similar to that of bladder malignancy in regards to its symptomatology. Painless gross hematuria and irritative lower urinary tract symptoms are symptoms that are commonly implicated in malignancies such as transitional cell carcinoma. ...
... Painless gross hematuria and irritative lower urinary tract symptoms are symptoms that are commonly implicated in malignancies such as transitional cell carcinoma. 3 This often makes the diagnosis of bladder amyloidosis elusive. More than 50% of bladder amyloidosis cases are initially diagnosed as bladder tumors, as CT findings show bladder wall thickening, mass lesion, or filling defects, making it hard to differentiate from an invasive bladder tumor. ...
... More than 50% of bladder amyloidosis cases are initially diagnosed as bladder tumors, as CT findings show bladder wall thickening, mass lesion, or filling defects, making it hard to differentiate from an invasive bladder tumor. 3 Furthermore, it can be difficult to diagnose this condition as its radiological appearance may mimic an inflammatory or neoplastic lesion, and its appearance on cystoscopy may show nodular to polypoidal masses. 2 Histologic diagnosis of this condition is essential. Bladder biopsies by transurethral resection can offer a definitive way to rule out malignancy. ...
Primary amyloidosis of the bladder is a rare clinical occurrence, with only a limited number of cases documented in literature thus far. Herein, is the presentation of a case involving a 75 year old male who presented with painless gross hematuria. Subsequent laboratory results and imaging completed were misleading, creating a high suspicion for bladder malignancy. Further workup revealed bladder biopsies to have positive apple-green birefringence with Congo-red immunostaining, diagnostic of amyloidosis.
The objective of this study was to describe the clinical spectrum of primary localized bladder amyloidosis (PLBA), its management options, outcomes, and follow-up. We retrospectively reviewed our medical records for patients with PLBA between April 2013 and April 2021. Patient’s demographics, imaging, cystoscopic characteristics, treatment, and outcomes were recorded and analyzed. Serum and urine electrophoresis, abdominal fat aspiration, and rectal biopsy results where available were also recorded. We identified 20 patients with PLBA with a median age of 56 years. Hematuria (80%) was the most common symptom followed by irritative lower urinary tract symptoms (iLUTS) (50%). The bladder lesions were focal, multiple, and diffuse in 4 (20%), 14 (70%), and 2 (10%) patients, respectively. All patients had transurethral resection of the bladder tumor, except for 4 patients with exclusive iLUTS who had cold cup biopsy. At a median follow-up of 43.9 months, 4 patients (20%) developed recurrence with median time to recurrence being 19 months. All the recurrences were managed endoscopically by re-resection and none of the patients required radical surgery. PLBA is a rare entity with varied clinical presentations. Although histologically benign, recurrences can occur and require long-term cystoscopic surveillance.
